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What does Added Sugars Intake have to do with Vitamin and Mineral Intakes?

Concerns about the health impact of dietary sugars, and “added sugars” in particular, continue to create buzz in the nutrition science and consumer arenas. Added sugars are sugars that are added to foods at the table, during processing or preparation, such as those added to chocolate milk, breakfast cereal, coffee drinks, and baked goods for sweetness and other functional properties. The 2005 Dietary Guidelines for Americans recommended that Americans limit consumption of added sugars partly because low intakes of essential vitamins and minerals may occur when the amount of added sugars in the diet exceed 25 percent of total calorie intake.

The critical factor in evaluating the health impact of any dietary component is understanding how much people consume, which foods contribute to its intake, and how both might be associated with the intake of other dietary components. To this end, the International Life Sciences Institute, North American Branch (ILSI NA) supported a recently published study1 which updated and expanded on the 2002 Institute of Medicine findings. The ILSI NA study, “Intake of added sugars and selected nutrients in the United States”, reports on 2003 to 2006 data from the National Health and Nutrition Examination Survey on (1) the amount of added sugars consumed by people in various age and gender groups, (2) the association between intakes of added sugars and essential nutrients, and (3) the foods contributing to added sugars intake. Individuals participating in the survey were grouped according to their consumption of added sugars into one of eight categories ranging from zero to more than 35 percent of calorie intake.

A majority of the study participants (87 percent) consumed less than 25 percent of calories from added sugars and more than half (56 percent) consumed less than 15 percent of calories from added sugars. Only about 13 percent had intakes of added sugars of 25 percent or greater of calorie intake. Whether their consumption of added sugars was more or less than 25 percent of their total calories, the study found that overall diet quality was poor for a significant portion of the US population. Across various age and gender groups, 17 to 100 percent of individuals failed to meet DRIs for vitamins A, C and E, calcium, zinc, potassium, magnesium and fiber. Iron was the only nutrient for which intakes were mostly consistent with the DRIs. When segmented by intake of added sugars category, nutrient intakes decreased as added sugars increased, particularly when intake was greater than 25 percent of calories. Also important is the fact that some individuals who consumed 15 percent or less of calories from added sugars had diets low in nutrients.

Results such as these may give the impression that consumption of added sugars has suddenly skyrocketed. However, an average 83 grams of added sugars was consumed per day by the overall population—an amount nearly identical to the 82 grams per day previously estimated using 1994-1996 survey data.2 In addition, foods contributing the largest amounts of added sugars in both surveys included beverages, sweetened grains (such as baked goods) and of course, sugars and sweets, candy, syrups, jams and jellies.

Since 1980, the U.S. Dietary Guidelines have based recommendations for added sugars intake on the available science of the time and have been primarily concerned with sugar’s contribution to total energy intake and impact on micronutrient intake. This recent analysis confirms that highest intakes of added sugars are associated with lower intake of essential nutrients. It also reveals that diet quality in the U.S. population is poor regardless of the amount of added sugars. Reducing added sugars intake alone will not improve overall dietary quality for all individuals. Additional emphasis needs to be placed on improving intake of fruits, vegetables, whole grains, and low and nonfat dairy products.